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Chen Y, Li J, Li F, Chen Z, Chen Z, Luo J, Qiu H, Chen W, Hu J, Luo X, Tan Y, Rathinasabapathy A, Chen J, Li J. Impact of Epicardial Adipose Tissue on Right Cardiac Function and Prognosis in Pulmonary Arterial Hypertension. Chest 2024; 165:1211-1223. [PMID: 38040053 DOI: 10.1016/j.chest.2023.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/11/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Although epicardial adipose tissue (EAT) is linked to effects on survival in left-sided heart failure, the association between EAT and right-sided heart failure caused by pulmonary arterial hypertension (PAH) remains unknown. RESEARCH QUESTION What are the potential impacts of EAT volume (EATV) on right ventricular function, biomarkers of myocardial injury, and long-term prognosis in patients with PAH? STUDY DESIGN AND METHODS A total of 135 age- and BMI-matched patients with PAH and 49 control participants were included in this study. EATV was quantified by using cardiac magnetic resonance and was related to clinical correlates, N-terminal pro-brain natriuretic peptide, and cardiac function. Levels of EATV associated with the risk of clinical worsening were evaluated on a continuous scale (restricted cubic splines) and by previously defined centile categories with Cox proportional hazards regression models and Kaplan-Meier survival estimates. RESULTS Compared with the control participants, patients with PAH had a lower EATV (ln [EATV], 3.2 ± 0.8 mL vs 3.5 ± 0.7 mL; P = .034). The association of EATV with right ventricular end-diastolic volume (Pnonlinear = .001), right ventricular end-diastolic volume index (P < .001), right ventricular cardiac output (P = .003), N-terminal pro-brain natriuretic peptide (P = .030), and the risk of clinical worsening (P = .014) was U shaped. Compared with individuals with middle-level EATV, multivariable-adjusted hazard ratio for clinical worsening was 6.0 (95% CI, 1.3-27.8) for the individuals with low-level EATV and 6.8 (95% CI, 1.5-30.2) for high-level EATV in patients with PAH. INTERPRETATION Patients with PAH had a decreased EATV compared with control participants. EATV exhibited a U-shaped association with right ventricular function and biomarkers of myocardial injury in patients with PAH. Low and high levels of EATV might reduce long-term event-free survival in patients with PAH. CLINICAL TRIAL REGISTRATION Chinese Clinical Trial Registry; No. ChiCTR2100049804; www.chictr.org.cn.
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Affiliation(s)
- Yusi Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Junli Li
- Department of Medical Imaging, Huizhou Municipal Central Hospital, Huizhou, China
| | - Fang Li
- Department of Radiology and Imaging, Zhuzhou Central Hospital of Central South University, Zhuzhou, China
| | - Zheng Chen
- School of Information Science and Technology, Shanghaitech University, Shanghai City, China
| | - Zhangling Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Jun Luo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Haihua Qiu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Wenjie Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Junjiao Hu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Xiaoqin Luo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Yingjie Tan
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | | | - Jingyuan Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Jiang Li
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China.
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Closs C, Vargas-Uricoechea H, Schwarzstein D, Lobo M, Lagranja E, Godinez-Leiva E, Nogueira JP. Relationship of subclinical hypothyroidism on epicardial adipose tissue: a systematic review and meta-analysis. Curr Probl Cardiol 2023; 48:101674. [PMID: 36841317 DOI: 10.1016/j.cpcardiol.2023.101674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/27/2023]
Abstract
Accumulation of epicardial adipose tissue (EAT) and Subclinical hypothyroidism (SH) are associated with increased cardio-metabolic risk. The objective of this study was to quantitatively compare EAT thickening between patients with SH and healthy controls. Therefore, after searching the PubMed/MEDLINE, Embase, Science Direct, Scopus, Google Scholar, and Cochrane databases; we analyzed a group of observational studies who compare the EAT changes between SH vs control groups. A total of 9 studies were included in the final analysis, for a total of 424 patients with SH and 330 controls. Random or fixed effects models were used. Pooled analysis revealed that HS increased EAT (MD: 1.0 mm [0.40; 1.50]; P < 0.01). This meta-analysis suggests that the amount of EAT is significantly increased in SH patients. EAT might be a marker of cardiovascular risk in patients with SH.
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Affiliation(s)
- Cecilia Closs
- Melian Medical Center, Av. 9 de Julio 243, CP: 3600, Formosa, Argentina; Endocrinology Service, Central Hospital of Formosa, Formosa, Argentina
| | - Hernando Vargas-Uricoechea
- Director of Metabolic Diseases Study Group, Department of Internal Medicine, Universidad del Cauca, Carrera 5 # 13N-36, Popayán, Cauca, Colombia
| | - Diego Schwarzstein
- Endocrinology Service of Integrated Clinics of Rosario, Rosario, Argentina
| | - Martin Lobo
- Council of Epidemiology and Prevention, Argentine Society of Cardiology, Azcuénaga 980, CP: 1115, Buenos Aires, Argentina
| | - Elena Lagranja
- Center for Research in Endocrinology, Nutrition and Metabolism, Faculty of Health Sciences, National University of Formosa, Argentina
| | - Eddison Godinez-Leiva
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL
| | - Juan Patricio Nogueira
- Center for Research in Endocrinology, Nutrition and Metabolism, Faculty of Health Sciences, National University of Formosa, Argentina..
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Wu JG, Yang WK, Huang HZ, Tang K, Zheng GD. MiRNA-6870-3p Regulates Lipopolysaccharide Induced Epicardial Adipose Tissue Inflammatory Genes via Targeting Tollip-Mediated JNK and NF-κB Signaling in Coronary Artery Disease. Int Heart J 2022; 63:915-927. [DOI: 10.1536/ihj.22-163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Jian-Guo Wu
- Department of Cardiac and Macrovascular Surgery, Central People's Hospital of Zhanjiang
| | - Wen-kai Yang
- Department of Cardiac and Macrovascular Surgery, Central People's Hospital of Zhanjiang
| | - Hao-Zong Huang
- Department of Cardiac and Macrovascular Surgery, Central People's Hospital of Zhanjiang
| | - Kai Tang
- Department of Cardiac and Macrovascular Surgery, Central People's Hospital of Zhanjiang
| | - Guang-Di Zheng
- Department of Cardiac and Macrovascular Surgery, Central People's Hospital of Zhanjiang
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Yontem M, Arslan S, Erdogdu BS, Kocak FE. SERUM LEVELS OF OXIDATIVE STRESS MARKERS IN SUBCLINICAL AND OVERT HYPOTHYROIDISM VERSUS CONTROL GROUP IN POPULATION OF KUTAHYA CITY, TURKEY. GOMAL JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.46903/gjms/19.04.935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Background: Overproduction of oxygen-related free radicals and inadequate antioxidant defense are critical in hypothyroidism, as they might lead to future life-threatening diseases. The objectives of this study were to compare serum levels of oxidative stress markers; total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), paraoxonase-1 (PON-1), and arylesterase (ARYL) in patients with subclinical hypothyroidism (SH) and overt hypothyroidism (OH) versus healthy controls in population of Kutahya city, Turkey.Materials Methods: This cross-sectional study was conducted at Department of Biochemistry, Faculty of Medicine, Kutahya University of Health Sciences, Kutahya, Turkey, from July to December, 2016. Three study groups of 45 each were formed as healthy controls, patients with SH and OH. Serum levels of TOS, TAS, OSI, PON-1, and ARYL were five research variables with ratio scale, but skewed, so described by median and IQR with 95% Cl. Kruskal-Wallis and multiple comparison tests were used for hypotheses testing.Results: Serum levels of TOS and OSI were higher in SH group (p-values 0.032; .0001; respectively) and OH group (p-values .0001; .0001, respectively) than healthy controls, while serum levels of TAS, PON-1 and ARYL were lower in SH group (p-values .0001; .0001; .0001, respectively) and OH group (p-values .0001; .0001; .0001, respectively) than control group.Conclusion: Our study showed that serum levels of TOS and OSI were higher in subclinical and overt hypothyroidism than in healthy controls; while serum levels of TAS, PON-1, and ARYL were lower in subclinical and overt hypothyroidism than in healthy controls.
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Allam MA, Nassar YA, Shabana HS, Mostafa S, Khalil F, Zidan H, Abo-Ghebsha M, Abdelghaffar A, Essmat A, Elmahdi E. Prevalence and Clinical Significance of Subclinical Hypothyroidism in Diabetic Peripheral Neuropathy. Int J Gen Med 2021; 14:7755-7761. [PMID: 34785933 PMCID: PMC8579825 DOI: 10.2147/ijgm.s337779] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/26/2021] [Indexed: 12/14/2022] Open
Abstract
Background and Aim Diabetic peripheral neuropathy (DPN) is one of the most common and disabling complications of DM. Many studies documented the prevalence of clinical and subclinical hypothyroidism (SCH) in diabetic patients but not in the particular group of patients with DPN. The present study aimed to determine the prevalence of SCH in DPN patients and to evaluate its association with severity of DPN. Patients and Methods The present cross-sectional study was conducted on 300 consecutive patients with DPN. The clinical manifestations of DPN were documented according to the validated Arabic version of the Michigan Neuropathy Screening Instrument. Severity of DPN was categorized into mild (6–8 points), moderate (9–11 points) or severe (12+ points) according to the Toronto Clinical Scoring System. All patients were submitted to careful history-taking and full clinical and neurological examination. Patients were diagnosed with SCH if they had TSH level above the upper limit of the normal reference range in association with normal free thyroxine (FT4) level. Results SCH was prevalent in 53 patients (17.7%, 95% CI: 13.5%–22.5%). Patients with SCH had significantly higher frequency of severe DPN (52.8% versus 28.3%, p=0.003). It was also shown that patients with SCH had significantly higher HbA1c (8.4 ± 1.0 versus 7.3 ± 1.2%, p<0.001) and HOMA-IR (3.7 ± 0.8 versus 2.7 ± 0.9, p<0.001) when compared with patients without SCH. Logistic regression analysis identified patients’ age [OR (95% CI): 1.06 (1.03–1.08), p<0.001], HbA1c [OR (95% CI): 2.2 (1.7–2.9), p<0.001] and SCH [OR (95% CI): 7.7 (3.6–15.5), p<0.001] as independent predictors of DPN severity. Conclusion The present study showed that SCH is highly prevalent in DPN patients and is independently related to its severity.
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Affiliation(s)
- Mahmoud A Allam
- Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Youssef A Nassar
- Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hosameldeen S Shabana
- Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Sadek Mostafa
- Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Farag Khalil
- Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hendawy Zidan
- Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohammed Abo-Ghebsha
- Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Amir Abdelghaffar
- Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Essmat
- Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Essam Elmahdi
- Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Nyawo TA, Pheiffer C, Mazibuko-Mbeje SE, Mthembu SXH, Nyambuya TM, Nkambule BB, Sadie-Van Gijsen H, Strijdom H, Tiano L, Dludla PV. Physical Exercise Potentially Targets Epicardial Adipose Tissue to Reduce Cardiovascular Disease Risk in Patients with Metabolic Diseases: Oxidative Stress and Inflammation Emerge as Major Therapeutic Targets. Antioxidants (Basel) 2021; 10:1758. [PMID: 34829629 PMCID: PMC8614861 DOI: 10.3390/antiox10111758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 12/25/2022] Open
Abstract
Excess epicardial adiposity, within a state of obesity and metabolic syndrome, is emerging as an important risk factor for the development of cardiovascular diseases (CVDs). Accordingly, increased epicardial fat thickness (EFT) implicates the exacerbation of pathological mechanisms involving oxidative stress and inflammation within the heart, which may accelerate the development of CVDs. This explains increased interest in targeting EFT reduction to attenuate the detrimental effects of oxidative stress and inflammation within the setting of metabolic syndrome. Here, we critically discuss clinical and preclinical evidence on the impact of physical exercise on EFT in correlation with reduced CVD risk within a setting of metabolic disease. This review also brings a unique perspective on the implications of oxidative stress and inflammation as major pathological consequences that link increased EFT to accelerated CVD risk in conditions of metabolic disease.
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Affiliation(s)
- Thembeka A. Nyawo
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town 7505, South Africa; (T.A.N.); (C.P.); (S.X.H.M.)
- Centre for Cardiometabolic Research in Africa (CARMA), Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa; (H.S.-V.G.); (H.S.)
| | - Carmen Pheiffer
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town 7505, South Africa; (T.A.N.); (C.P.); (S.X.H.M.)
- Centre for Cardiometabolic Research in Africa (CARMA), Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa; (H.S.-V.G.); (H.S.)
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
| | | | - Sinenhlanhla X. H. Mthembu
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town 7505, South Africa; (T.A.N.); (C.P.); (S.X.H.M.)
- Department of Biochemistry, North-West University, Mafikeng Campus, Mmabatho 2735, South Africa;
| | - Tawanda M. Nyambuya
- Department of Health Sciences, Faculty of Health and Applied Sciences, Namibia University of Science and Technology, Windhoek 9000, Namibia;
| | - Bongani B. Nkambule
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa;
| | - Hanél Sadie-Van Gijsen
- Centre for Cardiometabolic Research in Africa (CARMA), Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa; (H.S.-V.G.); (H.S.)
| | - Hans Strijdom
- Centre for Cardiometabolic Research in Africa (CARMA), Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa; (H.S.-V.G.); (H.S.)
| | - Luca Tiano
- Department of Life and Environmental Sciences, Polytechnic University of Marche, 60131 Ancona, Italy;
| | - Phiwayinkosi V. Dludla
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town 7505, South Africa; (T.A.N.); (C.P.); (S.X.H.M.)
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Tellechea ML. Meta-analytic evidence for increased low-grade systemic inflammation and oxidative stress in hypothyroid patients. Can levothyroxine replacement therapy mitigate the burden? Endocrine 2021; 72:62-71. [PMID: 32880055 DOI: 10.1007/s12020-020-02484-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This series of meta-analyses were aimed to elucidate the impact of hypothyroidism on low-grade systemic inflammation and oxidative stress assessed by C-reactive protein (CRP) and malondialdehyde (MDA) respectively; and to evaluate the effect of levothyroxine replacement therapy (LRT) on those outcomes. METHODS PubMed database and the key studies references were searched prior to March 3, 2020. Data on serum or plasma CRP and MDA levels in SHT (subclinical) and/or OHT (overt) hypothyroid patients and controls were extracted to compute overall standardized mean differences (SMD) by the random-effects model. RESULTS A total of 93 studies were entered into analyses and ten main meta-analyses were performed. OHT (SMD = 0.72 [0.39; 1.04], k = 35), SHT (SMD = 1.58 [0.78; 2.38], k = 56) and even mild SHT (TSH < 10 mU/L, SMD = 2.19 [0.02; 4.37], k = 13) proved to have a detrimental effect on CRP levels. LRT showed a favorable effect on CRP levels, particularly in OHT (SMD = -0.30 [-0.57; -0.02], k = 17). Increased levels of MDA were also found, especially in OHT (SMD = 2.49 [0.66; 4.31], k = 13). LRT may also improve MDA levels; however future studies would further validate the advantageous effect of LRT in hypothyroidism. Heterogeneity primarily originated from different study designs and geographic locations. CONCLUSION Overall, these meta-analyses reveal that screening for hs-CRP and MDA in hypothyroid patients as simple biomarkers of low-grade systemic inflammation and oxidative stress may become a useful tool to identify those at increased risk who may benefit most from early interventions.
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Affiliation(s)
- Mariana L Tellechea
- Centro de Investigaciones Endocrinológicas "Dr. César Bergadá" (CEDIE) CONICET - FEI - División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Gallo 1330, C1425EFD, Buenos Aires, Argentina.
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Nakanishi K, Daimon M, Yoshida Y, Sawada N, Hirose K, Iwama K, Yamamoto Y, Ishiwata J, Hirokawa M, Kaneko H, Nakao T, Mizuno Y, Morita H, Di Tullio MR, Homma S, Komuro I. Subclinical Hypothyroidism as an Independent Determinant of Left Atrial Dysfunction in the General Population. J Clin Endocrinol Metab 2021; 106:e1859-e1867. [PMID: 33049040 DOI: 10.1210/clinem/dgaa730] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/08/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Although subclinical hypothyroidism (SCH) is a common clinical entity and carries independent risk for incident heart failure (HF), its possible association with subclinical cardiac dysfunction is unclear. Left ventricular global longitudinal strain (LVGLS) and left atrial (LA) phasic strain can unmask subclinical left heart abnormalities and are excellent predictors for HF. This study aimed to investigate the association between the presence of SCH and subclinical left heart dysfunction in a sample of the general population without overt cardiac disease. METHODS We examined 1078 participants who voluntarily underwent extensive cardiovascular health check-ups, including laboratory tests and 2-dimensional speckle-tracking echocardiography to assess LVGLS and LA reservoir, conduit, and pump strain. SCH was defined as an elevated serum thyroid-stimulating hormone level with normal concentration of free thyroxine. RESULTS Mean age was 62 ± 12 years, and 56% were men. Seventy-eight (7.2%) participants exhibited SCH. Individuals with SCH had significantly reduced LA reservoir (37.1 ± 6.6% vs 39.1 ± 6.6%; P = 0.011) and conduit strain (17.3 ± 6.3% vs 19.3 ± 6.6%; P = 0.012) compared with those with euthyroidism, whereas there was no significant difference in left ventricular ejection fraction, LA volume index, LVGLS, and LA pump strain between the 2 groups. In multivariable analyses, SCH remained associated with impaired LA reservoir strain, independent of age, traditional cardiovascular risk factors, and pertinent laboratory and echocardiographic parameters. including LVGLS (standardized β -0.054; P = 0.032). CONCLUSIONS In an unselected community-based cohort, individuals with SCH had significantly impaired LA phasic function. This association may be involved in the higher incidence of HF in subjects with SCH.
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Affiliation(s)
- Koki Nakanishi
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Masao Daimon
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
- Department of Clinical Laboratory, The University of Tokyo, Tokyo, Japan
| | - Yuriko Yoshida
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoko Sawada
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazutoshi Hirose
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Kentaro Iwama
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuko Yamamoto
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Jumpei Ishiwata
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Megumi Hirokawa
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoko Nakao
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshiko Mizuno
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Shunichi Homma
- Department of Medicine, Columbia University, New York, New York
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
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Erdal E, İnanir M, Ustaoglu G, Sincer İ. Echocardiographic assessment of epicardial fat tissue thickness in patients with severe periodontitis. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.repce.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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10
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Echocardiographic assessment of epicardial fat tissue thickness in patients with severe periodontitis. Rev Port Cardiol 2020; 39:697-702. [PMID: 33234353 DOI: 10.1016/j.repc.2020.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 12/23/2019] [Accepted: 06/11/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This study aims to assess the thickness of epicardial fat tissue (EFT), a sign of cardiovascular risk, using echocardiography in patients with severe periodontitis. METHODS Thirty-three patients with stage III or IV periodontitis and 33 healthy participants were enrolled into the study. Epicardial fat tissue thickness was measured perpendicularly via echocardiography of the free wall of the right ventricular at end-diastole in three cardiac cycles. Body mass index (BMI) was calculated by dividing weight in kilograms by the height in meters squared. EFT to BMI ratio (EFT/BMI) was measured by dividing EFT by the BMI. RESULTS There was no significant difference between study patients and the control group as regards to the frequency of diabetes, hypertension, smoking, and hyperlipidemia. The EFT and EFT/ BMI ratio were significantly different in the control and periodontitis groups (0.51±0.17 vs. 0.77±0.16, respectively; p ≤0.001) (0.021±0.008 vs. 0.030±0.006, respectively; p≤0.001). Pearson's correlation coefficient demonstrated a significant relationship between EFT and the clinical parameters of periodontitis (p<0.001) CONCLUSIONS: EFT thickness measured by echocardiography appears to be associated with severe periodontitis and may thus be an indirect sign of cardiovascular disease in periodontitis patients.
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Farghaly HS, Metwalley KA, Raafat DM, Algowhary M, Said GM. Epicardial Fat Thickness in Children with Subclinical Hypothyroidism and Its Relationship to Subclinical Atherosclerosis: A Pilot Study. Horm Res Paediatr 2020; 92:99-105. [PMID: 31618734 DOI: 10.1159/000503287] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/09/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Thyroid hormones (TSH) play a key role in the working of the cardiovascular system, with direct effects on cardiac function, vascular system, and atherosclerotic factors. Epicardial adipose tissue, the visceral fat of the heart, has emerged as a new cardiometabolic risk marker because of its close anatomical proximity to the myocardium and coronary artery. This study aimed to evaluate epicardial fat thickness (EFT) in children with subclinical hypothyroidism (SH) and its relation to early atherosclerotic changes. METHODS The study included 32 children with SH due to autoimmune thyroiditis and 32 healthy children matched for age and gender as control group. Patients and controls underwent anthropometric evaluation and measurement of fasting lipids, glucose, insulin, homeostasis model assessment for insulin resistance and high-sensitivity C-reactive protein (hs-CRP). TSH, free thyroxine (FT4 and FT3) and antithyroid autoantibodies (antithyroid peroxidase and thyroglobulin antibodies) were also measured. Conventional echo-cardiography was used to assess EFT. Noninvasive ultrasound was used to measure carotid intima-media thickness and brachial artery flow-mediated dilation (FMD) responses. RESULTS Compared to controls, patients had higher atherogenic index (AI) and hs-CRP (p = 0.001 for each). Conventional echocardiography revealed that patients with SH had higher EFT (p = 01) and significantly lower FMD response compared with the control (p = 0.001). In multivariate analysis, EFT values were significantly correlated with TSH (OR 1.2; 95% CI 1.04-1.34; p = 0.01), hs-CRP (OR 1.1; 95% CI 1.09-1.14; p = 0.001, AI (OR 1.6; 95% CI 1.17-2.03; p = 0.001), and FMD response (OR 2.4; 95% CI 1.14-2.53; p = 0.01). CONCLUSIONS Our study demonstrated that EFT is higher in children with SH compared with controls and associated with FMD responses. Measurement of EFT by echocardiography in children with SH may help to identify those at high risk of developing subclinical atherosclerosis.
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Affiliation(s)
- Hekma Saad Farghaly
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt,
| | | | - Duaa Mohamed Raafat
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Magdy Algowhary
- Department of Cardiology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ghada Mohamed Said
- Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
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Erdogan MA, Yalcin A. Protective effects of benfotiamine on irisin activity in methotrexate-induced liver injury in rats. Arch Med Sci 2020; 16:205-211. [PMID: 32051725 PMCID: PMC6963132 DOI: 10.5114/aoms.2018.80002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 10/27/2018] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Methotrexate (MTX) causes hepatotoxicity by producing oxidative stress. Benfotiamine and irisin have protective effects against oxidative stress. The aim of this study was to investigate the changes in irisin activity in the liver as a result of toxicity produced by MTX and the protective role of benfotiamine in the hepatotoxicity. MATERIAL AND METHODS Rats were divided into 4 groups as follows: control, benfotiamine (50 mg/kg, oral gavage (o.g.), for 14 days), MTX (MTX 20 mg/kg intraperitoneally (i.p.) on day 1), MTX + benfotiamine (MTX 20 mg/kg (i.p.) on day 1, then 50 mg/kg (o.g.) benfotiamine for 14 days). Liver tissue was used to examine histopathological and immunohistochemical changes. Serum was used to look for oxidative stress markers (total antioxidant status (TAS) and total oxidant status (TOS)). RESULTS Administration of MTX caused a significant TOS increase and TAS decrease in the serum as compared to the control group. Immunohistochemically, irisin was significantly increased in immunoreactivity in the MTX group as compared to the control group (p < 0.05). Significant histopathological improvement and decrease in serum TOS levels were observed in the MTX + benfotiamine group compared to the MTX group (p < 0.05). In addition, an increase in TAS level and a decrease in irisin immunoreactivity were observed but they were not statistically significant (p > 0.05). CONCLUSIONS Our results showed that MTX caused an increase in the activity of irisin after producing toxicity in the liver. In addition, we found that benfotiamine was effective in preventing damage caused by MTX in the liver.
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Affiliation(s)
- Mehmet Ali Erdogan
- Department of Gastroenterology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Alper Yalcin
- Department of Histology and Embryology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
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Dong XF, Kong FZ, Shen MQ, Huang J, Gao ZE, Guo QZ, Zhao Z, Luo WF, Cheng QZ, Wu GH. Triiodothyronine levels were positively correlated with opening of collateral circulation in cerebral infarction patients with large artery atherosclerosis. Arch Med Sci 2020; 16:51-57. [PMID: 32051705 PMCID: PMC6963139 DOI: 10.5114/aoms.2020.91286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 07/21/2017] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Non-thyroidal illness syndrome (NTIS) is one of the signs for poor prognosis of cerebral infarction (CI), but its risk factors had never been explored. In this study, we analyzed the potential effect of collateral circulation on prognosis prediction of triiodothyronine for large artery atherosclerosis cerebral infarction (LAA-CI) patients. MATERIAL AND METHODS Clinical data of CI patients between 2012 and 2014 were collected. Imaging inspection was used for determining TOAST classification and evaluating collateral circulation. One-year follow-up was conducted for mRS score by telephone. RESULTS T3 level in the NTIS group (p = 0.001) was significantly decreased while TSH level (p < 0.001) was increased. Patients in the NTIS group had a poorer prognosis (p = 0.008) and the main reason was the high mortality (p = 0.002). NTIS predicted poor collateral circulation (p = 0.026) and good collateral circulation tended to be less likely concomitant with NTIS (p = 0.001). Logistic regression analysis showed that triiodothyronine concentrations (OR = 4.760, 95% CI: 1.981-11.456, p < 0.001) were positively correlated with but advanced age (OR = 0.756, 95% CI: 0.645-0.886, p = 0.001) negatively with opening of collateral circulation. CONCLUSIONS Poor opening of collateral circulation was likely to mediate the prediction of NTIS for prognosis of LAA-CI patients.
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Affiliation(s)
- Xiao-Feng Dong
- Neurology Department, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Fan-Zhen Kong
- Department of Psychology, Suzhou Guangji Hospital, Suzhou Psychiatric Hospital, Suzhou, China
| | - Ming-Qiang Shen
- Neurology Department, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Jiang Huang
- Ophthalmology Department, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Zong-En Gao
- Neurology Department, Shengli Oilfield Central Hospital, Suzhou, China
| | - Qian-Zhu Guo
- Neurology Department, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Zhong Zhao
- Neurology Department, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Wei-Feng Luo
- Neurology Department, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Qing-Zhang Cheng
- Neurology Department, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Guan-Hui Wu
- Neurology Department, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
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Microenvironment of Immune Cells Within the Visceral Adipose Tissue Sensu Lato vs. Epicardial Adipose Tissue: What Do We Know? Inflammation 2018; 41:1142-1156. [PMID: 29846855 DOI: 10.1007/s10753-018-0798-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The chronic low-grade inflammation of the visceral adipose tissue is now fully established as one of the main contributors to metabolic disorders such as insulin resistance, subsequently leading to metabolic syndrome and other associated cardiometabolic pathologies. The orchestration of immune response and the "ratio of responsibility" of different immune cell populations have been studied extensively over the last few years within the visceral adipose tissue in general sense (sensu lato). However, it is essential to clearly distinguish different types of visceral fat distribution. Visceral adipose tissue is not only the classical omental or epididymal depot, but includes also specific type of fat in the close vicinity to the myocardium-the epicardial adipose tissue. Disruption of this type of fat during obesity was found to have a unique and direct influence over the cardiovascular disease development. Therefore, epicardial adipose tissue and other types of visceral adipose tissue depots should be studied separately. The purpose of this review is to explore the present knowledge about the morphology and dynamics of individual populations of immune cells within the visceral adipose tissue sensu lato in comparison to the knowledge regarding the epicardial adipose tissue specifically.
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Yao K, Zhao T, Zeng L, Yang J, Liu Y, He Q, Zou X. Non-invasive markers of cardiovascular risk in patients with subclinical hypothyroidism: A systematic review and meta-analysis of 27 case control studies. Sci Rep 2018; 8:4579. [PMID: 29545561 PMCID: PMC5854616 DOI: 10.1038/s41598-018-22897-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/01/2018] [Indexed: 12/18/2022] Open
Abstract
It has been reported that subclinical hypothyroidism (SCH) is closely related to subclinical atherosclerosis. According to the impact of SCH on noninvasive markers of cardiovascular risk, we fulfilled a meta-analysis of included studies to provide an integrated overview. We searched electronic databases and included all relevant studies involving SCH and epicardial adipose tissue (EAT), carotid intima-media thickness (CIMT), pulse wave velocity (PWV), flow-mediated dilation (FMD) and glyceryl trinitrate-induced dilation (GNT- induced dilation). The result was calculated in a meta-analysis to assess the impact of SCH on these markers. A total of 27 studies were entered in the final analysis. Compared with euthyroid subjects, SCH patients exhibited a significantly increased CIMT (SMD: 0.369 mm; 95%CI: 0.038, 0.700; P = 0.029) and EAT (SMD: 1.167 mm; 95%CI: 0.869, 1.466; P = 0.000) and increased PWV (SMD: 3.574 m/s; 95%CI: 0.935, 6.213, P = 0.008). We also found significantly lower FMD (SMD: −1.525%, 95%CI: −2.156, −0.894, P = 0.000) and lower GNT-induced dilation (SMD: −0.384%, 95%CI: −0.625, −0.142, P = 0.002). Sensitivity analysis and subgroup analysis confirmed the above results. Our meta-analysis confirmed a significant association of SCH and cardiovascular risk with arterial wall thickening and stiffening and endothelial dysfunction. These findings will help to establish detailed cardiovascular prevention strategies for SCH patients.
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Affiliation(s)
- Kecheng Yao
- Department of Gerontology, The People's Hospital of China Three Gorges University & The First People's Hospital of Yichang, Yichang, 443000, Hubei Province, China
| | - Tianming Zhao
- Department of Respiratory and Critical Care Medicine, The People's Hospital of China Three Gorges University & The First People's Hospital of Yichang, Yichang, 443000, Hubei Province, China
| | - Linghai Zeng
- Department of Gerontology, The People's Hospital of China Three Gorges University & The First People's Hospital of Yichang, Yichang, 443000, Hubei Province, China
| | - Jianming Yang
- Department of Endocrinology, The People's Hospital of China Three Gorges University & The First People's Hospital of Yichang, Yichang, 443000, Hubei Province, China
| | - Yanqun Liu
- Department of Endocrinology, The People's Hospital of China Three Gorges University & The First People's Hospital of Yichang, Yichang, 443000, Hubei Province, China
| | - Qian He
- Department of Gerontology, The People's Hospital of China Three Gorges University & The First People's Hospital of Yichang, Yichang, 443000, Hubei Province, China
| | - Xiulan Zou
- Department of Gerontology, The People's Hospital of China Three Gorges University & The First People's Hospital of Yichang, Yichang, 443000, Hubei Province, China.
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Chen Y, Wu G, Xu M. The effect of L-thyroxine substitution on oxidative stress in early-stage diabetic nephropathy patients with subclinical hypothyroidism: a randomized double-blind and placebo-controlled study. Int Urol Nephrol 2017; 50:97-103. [PMID: 29196928 DOI: 10.1007/s11255-017-1756-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/20/2017] [Indexed: 12/29/2022]
Abstract
PURPOSE To study oxidative stress status of early type 2 diabetic nephropathy (DN) patients with subclinical hypothyroidism (SCH) and to assess effect of L-thyroxine therapy on the oxidative stress in these patients. METHODS It is a randomized double-blind and placebo-controlled trial. A total of 48 patients with early type 2 DN were included as Euthyroid group, and 92 early type 2 DN with SCH were selected and randomly assigned to L-thyroxine treatment group (LT4 group) and placebo group (SCH group). Changes in urinary albumin excretion rate (UAER), serum malondialdehyde (MDA), superoxide dismutase (SOD) activity, urine 8-hydroxyl deoxyguanosine (8-OHdG), serum creatinine, estimated glomerular filtration rate, and lipid profile before and after 24 weeks of follow-up were examined and compared. RESULTS The levels of UAER, MDA, 8-OHdG were higher, while the SOD activity was lower in DN patients with SCH than in DN patients (p < 0.05 for all). In the LT4 group, the levels of UAER, MDA, 8-OHdG decreased significantly (p < 0.05) to levels no longer different from the Euthyroid group. The SOD activity increased significantly. But in SCH group, the levels of mAlb, MDA, 8-OHdG were greater after 24 weeks of follow-up and greater than patients in the Euthyroid group. SOD activity decreased significantly after 24 weeks in the SCH group (p < 0.05). CONCLUSION Oxidative stress is greater in the DN patients with SCH, and SCH may exacerbate kidney injury in early DN patients. The LT4 treatment may decrease the oxidative stress and attenuate renal injury in DN patient with SCH.
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Affiliation(s)
- Yong Chen
- Department of Nephropathy, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, 228 Jingui Road, Xianning, 437100, China
| | - Ganlin Wu
- Department of Medicine, School of Clinical Medicine Sciences, Hubei University of science and Technology, 88 Xianning Road, Xianning, 437100, China.
| | - Meirong Xu
- Department of Medicine, The Second Affiliated Hospital of Hubei University of Science and Technology, 58 Chahua Road, Xianning, 437100, China
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